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cbd oil dose for fibromyalgia

CBD Oil for Fibromyalgia – Is It the Solution?

Around 2 million people in the UK suffer from fibromyalgia, a neurological disorder resulting in widespread chronic pain for which there is currently no cure available.

Painkillers and antidepressants are prescribed to help manage the symptoms, but the benefits, if any, are often surpassed by the terrible side effects. This has led patients and their families to search for safer alternative treatments, such as cannabidiol (CBD).

CBD popularity surged when heartfelt videos of children with epilepsy becoming seizure-free went viral. It can also people with anxiety, depression chronic pain and their sex life. This was quickly followed by clinical trials that proved what advocates always knew; the plant can be a medicine.

Encouraging as this is, can cbd oil for fibromyalgia really relief some of the symptoms?

Fibromyalgia was once considered a fictitious disease, but then again so too were the medicinal properties of the cannabis plant. As both theories have now been disproved many people are now using this wonderous plant to help with an array of ailments.

But what exactly is CBD and is there evidence to back up the claims that fibromyalgia patients may benefit from using it?

Understanding CBD Oil

CBD is one of more than 120 cannabinoids extracted from the flower and leaf of the cannabidiol-rich cannabis plant. A strain that contains only a negligible amount of the psychotropic tetrahydrocannabinol (THC) cannabinoid and as such will never result in any euphoric ‘high’ feeling typically associated with cannabis.

CBD interacts with receptors located in the human endocannabinoid system (ECS), a molecular signalling system that promotes wellness by regulating biological systems.

The ECS regulates a variety of cognitive and physiological processes including mood, memory, inflammation, and appetite, but one aspect fibromyalgia patients will be interested in is how this cannabinoid can help with chronic pain relief.

CBD Oil for Fibromyalgia – How Does It Work?

CBD acts simultaneously on multiple pain targets by interacting with receptors located throughout the peripheral and central nervous system(CNS) – the pathway in which pain signals travel along. A pathway that is distorted in fibromyalgia patients.

When we experience sensory damage (burns, cuts etc), our brain is informed of this by peripheral sensory neurons known as nociceptors and responds by making us feel pain.

Cannabidiol regulates this perception of pain by affecting the activity of serotonin receptors which are known to influence pain through spinal processing of nociceptive information.

In addition to this, activation of CB2 receptors on keratinocytes (skin cells) stimulates the release of β-endorphin, which acts at μ opioid receptors on peripheral sensory neurons to inhibit the message of pain from nociception information.

Furthermore, when the body is in distress it naturally produces an endogenous cannabinoid known as anandamide which has been shown to suppress pain initiation. Unfortunately, this molecule is eradicated quickly from the body by an enzyme known as ‘fatty acid amide hydrolase’ or FAAH.

CBD inhibits FAAH thereby slowing down anandamide decomposition resulting in further pain suppression which may help fibromyalgia patients experience more pain relief.

Is CBD Effective for Fibromyalgia Pain?

CBD can help manage the chronic pain associated with fibromyalgia by directly or indirectly interacting with the receptors located throughout the body responsible for the perception of pain.

Cannabidiol has the ability to affect serotonin levels, anandamide levels, and opioid receptors all of which are known to influence our perception of pain.

Fibromyalgia patients experience a much more heightened form of pain due to the confusion that arises when chemical signals are being sent to and from the brain, but this unique molecule may have the potential to mitigate some of these ‘crossed wires’…

Chemical information messengers called neurotransmitters interact with glial cells which play a vital role in the spinal cord with regards modulation and amplification of pain, something that is exacerbated in patients with fibromyalgia.

Professor of anesthesiology at Stanford University, Dr. Elliot Krane, says that “when these glial cells become activated they can create a positive feedback loop” where “pain becomes its own disease” offering only rare and brief glimpses of respite.

This results in nervous system plasticity changes whereby the sensory experience we call pain is amplified and ultimately distorted. Existing medications, when they work, simply mask these problems whereas cannabidiol may offer a solution.

A 2017 study from Israel showed astrocyte (glial cells) activity to be suppressed by the presence of CBD in models of ischemia, Alzheimer-like and Multiple-Sclerosis-like neurodegenerative, sciatic nerve injury, epilepsy, and schizophrenia.

So If CBD does all this, why is it not recommended by doctors for fibromyalgia?

Why Has My Doctor Not Recommended CBD?

An NHS doctor may only prescribe Cannabis oil for certain conditions such as treatment-resistant epilepsy, or nausea from chemotherapy.

All other conditions, regardless of the research available, can not legally be suggested for CBD treatment without prior extensive and incredibly expensive clinical trials.

Thankfully though, CBD is classified as a food supplement in the UK and most parts of the world and as such is available throughout the country. But does that make it legal?

Is It Legal to Treat Fibromyalgia With CBD?

CBD is legal to purchase, consume, and help treat patients living with fibromyalgia in the UK. The only caveat is that manufacturers and retailers may not advertise it as a cure or remedy for symptoms or illnesses of any disease.

Purchasing the oil is the easy part but due to its classification as a food supplement it is difficult to get advice from UK health authorities on dosage, but there are a lot of resources out there that you can turn to.

Guidelines of CBD Dosage for Fibromyalgia

In all human studies, cannabidiol has been shown to exhibit a bell-shaped dose-response curve meaning the effects and benefits work at different dosage strengths for different people. It is not simply a case of more is better.

Dr. Sarah Brewer, a medical director and medical nutritionist at UK group ‘Healthspan’ says: “For General well-being, the recommended dose is 10 mg to 200 mg per day as a food supplement.”

Double-blind placebo-controlled studies into adults with anxiety showed 300 mg being the optimum dosage but this may not feasible for everyone and anecdotal evidence suggests effects can actually be found at much lower doses.

The best dosage advice is always to start small and slow. Every person has their own unique endocannabinoid system and the right dosage amount will often vary based on :

  • Height & Weight
  • Your body’s tolerance to CBD
  • Condition being treated
  • Concentration/strength of the product

The below diagram will give you a really good base to work from until you find the dosage right for you.

Due to an ever-growing market, there are a growing number of ways of getting CBD into your body, resulting in more and more innovative ways with something to suit everyone and every palate.

Topicals

Topicals include salves, balms, and creams that contain typical skincare ingredients infused with CBD oil. Topicals are applied directly to the site of pain or infection to work on that specific area. They can also be used to improve conditions such as acne and to also just give you clearer, better-looking skin. These are particularly popular for people with skin conditions, muscular pains and joint aches.

Smoking or Vaping

Smoking and vaping CBD involves flower or oil being burned (smoked) or heated (vaped) and entering the lungs. Pulmonary absorption results in a rapid onset of effects. Those looking for immediate relief should opt for vaping flower rather than smoking as it does not have the toxins that are created from combustion.

Tinctures

Tinctures provide an easy, effective and ideal medium for precise dosing. Using a pipette, drops are placed under the tongue where there are numerous veins that quickly absorb the oil into the circulatory system.

Edibles

For some, the taste of cannabidiol can be too strong and if that is the case then edibles such as delicious cakes, chocolates, gummy bears, CBD drinks are all great options.

Capsules/Gelcaps

Capsules offer a precise method for those looking for accurate dosing. With different strengths available, as well as a vegetarian option, there is a capsule for everyone.

Oromucosal

Another fast and effective method similar to tinctures is the oromucosal method in which CBD is sprayed into the mouth and gums and quickly absorbed into the circulatory system.

Intranasal

Using a special spray bottle CBD oil is breathed into the nose where thin mucosa absorbs the oil for fast-acting results.

Rectal Suppositories

For those who, for whatever, reason cannot swallow capsules, edibles, etc, there are suppositories which can be taken and are absorbed into the cellular walls and mucous membranes of the anus.vThe lower and middle veins allow CBD to bypass the digestive system, therefore rapidly entering the bloodstream

CBD Oil – Are There Side Effects?

CBD oil has a remarkable safety profile which was confirmed by a 2017 study of clinical data and animal studies. Researchers even concluded that “CBD has a better side effect profile in comparison to ‘traditional’ drugs.”

The majority of studies looked at epilepsy and psychotic disorders with the most commonly reported side effects reported being:

  • Tiredness
  • Diarrhoea
  • Changes in appetite/weight.
  • Potential drug on drug interactions

Tiredness

CBD oil is being used to aid sleep and as such larger doses may bring on some drowsiness. In epilepsy studies using epidiolex (patented CBD mixture with other ingredients), 21% experienced tiredness.

Diarrhoea

Diarrhoea is only mentioned as a side effect in 10% of epilepsy participants who received epidiolex whereas in other studies of pure CBD (nothing added) there is no mention of diarrhoea as a side effect.

Changes in Appetite/Weight

Again in epilepsy clinical trials, 16% of participants reported reduced appetite. Weight loss was reported in 2% of trialists.

Drug on drug Interactions

Cannabidiol may interact with enzymes in your liver potentially increasing or decreasing pharmaceutical drugs. Something anyone on blood thinners, for example, should consult their doctor prior to use

Interestingly this is not necessarily a negative as in one 13 week study of children, CBD increased the bioavailability of the anti-epileptic drug and in turn reduced the dosage required resulting in fewer side effects.

Conclusion

Cannabidiol has the ability to mimic certain endogenous cannabinoids functions by interacting directly or indirectly with receptors located throughout the body. This results in a plethora of potential medicinal benefits using cbd oil for fibromyalgia patients including providing chronic pain relief, reduced inflammation and anti-anxiety effects.

Considering its safety profile and infrequent, mild potential side effects CBD oil would certainly be prudent for patients and their families to do their own research and seriously consider this alternative to synthetic pharmaceutical drugs.

It is also worth reiterating the importance of premium, 3rd party independently tested oil to ensure the product you receive is the highest quality, as inferior products often contain no CBD at all. A better quality product will offer significantly better results.

Finally, there is a clear consensus that starting small and slow is the best option so you find the right dosage that works for you.

Learn all about using CBD oil for Fibromyalgia with this guide from Candid. It's known to help with chronic pain so it should ease peoples suffering!

CBD For Fibromyalgia: Research, Benefits, & Dosage

Cannabis has shown potential as a safe and natural alternative for treating chronic pain and inflammation involved with fibromyalgia.

Here’s how it works.

Article By

Roughly 2% of the population will receive a diagnosis of fibromyalgia in their life-time [1].

There’s no cure for fibromyalgia — and most treatment options and their effectiveness will vary from person to person [2].

Let’s take a look at fibromyalgia and the effects of CBD on this chronic condition. This may shed some light on why CBD is so popular among people suffering from fibromyalgia.

MEDICALLY REVIEWED BY

Updated on November 07, 2020

Table of Contents
  • Benefits of CBD for Fibromyalgia
    • 1. Alleviates Chronic Pain
    • 2. May Improve Sleep
    • 3. Fights Anxiety & Depression Symptoms
  • What’s The Dose of CBD For Fibromyalgia?
    • CBD Dosage Calculator
  • Is CBD Safe?
  • What is Fibromyalgia?
    • Symptoms of Fibromyalgia
      • The Most Common Symptoms of Fibromyalgia Include:
    • Common Comorbidities of Fibromyalgia
    • What’s The Cause of Fibromyalgia?
    • How is Fibromyalgia Diagnosed?
  • How Is Fibromyalgia Treated?
    • An individual treatment plan may include some or all of the following:
    • Common Therapies for Fibromyalgia:
    • Common Medications for Fibromyalgia:
  • Lifestyle & Self-Care Tips For Fibromyalgia
    • 1. Relaxation Strategies
    • 2. Sleep Hygiene
    • 3. Regular Exercise
    • 4. Eat a Balanced Diet
      • Eat to Increase Energy
      • Follow a Low FODMAP Diet
      • Go Vegetarian or Vegan
      • Increase Your Magnesium
      • Avoiding Gluten
  • Key Takeaways: Using CBD For Fibromyalgia
  • References:
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    Benefits of CBD for Fibromyalgia

    CBD is a promising alternative for people suffering from fibromyalgia. The primary benefits come from CBDs’ ability to affect the endocannabinoid system — which in turn affects neuronal and microglial activity.

    In basic terms, CBD is able to influence the behavior of cells that transmit pain and cells that cause inflammation in the central nervous system.

    When the stress response is managed effectively, symptoms of fibromyalgia can be ameliorated.

    CBD is also useful as an anti-inflammatory, and analgesic for the condition, which are two of the most prominent side-effects of the condition.

    The benefits of CBD oil for fibromyalgia include:

    • Alleviates chronic pain & inflammation
    • May support sleep quality
    • Fights anxiety & depression

    1. Alleviates Chronic Pain

    There’s a wealth of anecdotal reports on the effectiveness of CBD at reducing chronic pain, such as the kind experienced in fibromyalgia. In a study on joint pain, preclinical studies show that there is an interaction between CBD and the ECS, which may explain CBD’s analgesic properties [7].

    2. May Improve Sleep

    Another study showed that CBD interacts with astrocyte activity. This is yet another piece of information that can explain why taking CBD is able to affect a myriad of neurological symptoms. Astrocytes are a type of cell in the brain that regulates the synaptic activity and inflammation [8].

    CBD has shown positive effects on regulating the quality and quantity of sleep thanks to its calming and anti-anxiety properties [9].

    3. Fights Anxiety & Depression Symptoms

    Various preclinical trials and small double-blind studies have shown that CBD works well to treat anxiety and depression along with other neurological issues.

    One of the primary ways CBD works to relieve symptoms of depression is by eliminating underlying inflammation in the brain — which is closely linked with depression [10].

    What’s The Dose of CBD For Fibromyalgia?

    The dose of CBD for fibromyalgia can vary a lot from one person to the next. Everybody responds differently, so it’s important to start low and go slow with your CBD dosing. If you are new to taking CBD, it’s advised to start on the smallest dose according to the instructions of the product you are using. Gradually increase by 5-10 mg until you feel you have reached your optimal dose.

    By starting at a lower dose and gradually increasing over time you can find the right dose without going overboard and causing negative side-effects like sedation or dry mouth.

    Most people with fibromyalgia require a higher dose of CBD to receive maximum benefits.

    Keep a journal of your dosages, timings, and symptoms to find or adjust the amount that is optimal for you.

    Fibromyalgia patients will often take CBD oil as drops below the tongue, and/or apply a topical CBD cream or gel onto the affected areas.

    CBD Dosage Calculator

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    Is CBD Safe?

    CBD is safe, well-tolerated and rarely produces side effects even with high doses. When side-effects are experienced, they tend to be mild, including things like dizziness, dry mouth, or sedation.

    There’s evidence that tolerance to the compound doesn’t develop, unlike other treatment options like opioid medications (such as Oxycontin) [14]

    It’s important to note that research is based on using pure, high-quality CBD oils that don’t contain synthetic additives or preservatives.

    What is Fibromyalgia?

    Fibromyalgia is a chronic illness that causes widespread pain throughout the body — often accompanied by symptoms such as fatigue, insomnia, depression, and problems with memory and concentration.

    Fibromyalgia isn’t life-threatening — but it has a tremendous physical and social impact on those affected.

    There is increasing evidence that stress and depression play a significant role in the development of fibromyalgia.

    Scientists have found that the body’s two stress systems — the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system — are altered in people with fibromyalgia.

    Basically, the HPA axis is the major part of the system that controls your physiological reaction to stress. If this system is dysfunctional, it becomes significantly more difficult to manage stressful situations.

    One of the most common side-effects is chronic, widespread pain — a symptom widely exhibited in fibromyalgia.

    Symptoms of Fibromyalgia

    Each person will have his or her own set of symptoms, which can be mild, moderate or severe. Symptoms can even disappear from time to time, lasting weeks, months, or years before coming back.

    The Most Common Symptoms of Fibromyalgia Include:
    1. Widespread pain
    2. Sensitivity to cold and heat, light, smell
    3. Extreme fatigue
    4. Irregular sleeping patterns
    5. Cognitive difficulties often referred to as “fibro fog”

    Common Comorbidities of Fibromyalgia

    • Irritable bowel syndrome (IBS)
    • Restless leg syndrome (RLS)
    • Migraines and headaches
    • Interstitial cystitis or painful bladder syndrome
    • Depression and anxiety
    • Skin problems

    What’s The Cause of Fibromyalgia?

    We still don’t know what causes fibromyalgia, but it appears to be factors like genetics, past illnesses, injuries, or past emotional and physical stress.

    Risk factors for fibromyalgia include:

    • Family history of fibromyalgia
    • Physical or emotional injury or trauma
    • Illness such as a virus or infection
    • Lupus, ankylosing spondylitis (spinal arthritis) or rheumatoid arthritis
    • Anxiety, depression, and emotional stress
    • Sleep deprivation
    • Smoking
    • Being overweight
    • Heightened stress

    How is Fibromyalgia Diagnosed?

    Over time, guidelines have changed in the methods used to diagnose fibromyalgia. In the past, doctors would diagnose fibromyalgia by identifying specific tender points in at least 11 of 18 specified sites. Patients also must have been experiencing widespread pain for at least the past 3 months.

    Now, more recent guidelines have been developed as a simple, practical criterion for diagnosis involving the following:

    • Widespread pain lasting more than three months.
    • Symptom severity score involving fatigue, waking unrefreshed, and poor cognitive function.
    • No underlying disorders that could explain symptoms.

    There are no specific lab tests that can confirm a diagnosis, though doctors may recommend blood tests, x-rays, and specialized scans, such as nuclear medicine and CT scans.

    Tests used to diagnose fibromyalgia may include:

    1. Full blood count — including testing for adrenal and thyroid function. Hypothyroidism can cause symptoms that mimic those of fibromyalgia
    2. Vitamin D testing — a deficiency in vitamin D can cause similar symptoms to fibromyalgia

    Doctors will try to rule out everything that can be tested for, ensuring the exclusion of autoimmune conditions that can mimic the symptoms of fibromyalgia. If nothing else is identified and the patient checks the criteria for fibromyalgia, a diagnosis is made.

    How Is Fibromyalgia Treated?

    Fibromyalgia can be difficult to treat. This is primarily because the condition presents slightly different for everybody.

    Since there is no direct cause for fibromyalgia, treatment of symptoms requires trial and error, repeated doctor visits, and a combination of both lifestyle changes and medication.

    An individual treatment plan may include some or all of the following:
    • Physical therapy
    • Counseling
    • Exercise program
    • Antidepressant medications
    • Meditation and yoga
    • Acupuncture
    • Reflexology
    • Massage therapy
    Common Therapies for Fibromyalgia:
    1. Physical therapy — physical therapists can guide you with exercises that will improve muscular strength, flexibility, and stamina to reduce pain. Hydrotherapy (water-based exercise) can be beneficial.
    2. Psychotherapy — counseling may help to relieve symptoms of stress and provide skills in stress resilience.
    3. Occupational therapy — occupational therapists can make the necessary adjustments in your workplace to make tasks easier to perform.
    Common Medications for Fibromyalgia:
    1. Pain Medications — used alone or in combination, paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) are often used to treat pain. Benzodiazepines such as Valium are commonly used to relax muscles and treat anxiety and tension.
    2. Narcotic analgesics or opioids — these medications are used when all other medications have failed to help treat the symptoms of fibromyalgia. They can potentially form a dependency and are usually only prescribed for a short period. Oxycodone (OxyContin) is a common opioid analgesic.
    3. Antidepressants — Selective serotonin reuptake inhibitors (SSRIs) such as Cymbalta, Savella, Prozac or Paxil may help with pain and sleep disturbances; the same goes for tricyclic antidepressants such as Pamelor and Elavil. However, adverse events, tolerance development, and weight gain are common side effects of some antidepressants.
    4. Antiepileptic drugs — these are used for their sleep-promoting and anxiolytic actions. Lyrica and Neurontin can be prescribed for their ability to slow down nerve signals from the muscles to the brain to reduce pain and muscle spasms. Side effects of dependency and weight gain are frequent deterrents for its use.

    Lifestyle & Self-Care Tips For Fibromyalgia

    Fibromyalgia is a chronic condition that is affected by many factors, including diet and lifestyle choices. Therefore, treatment needs to involve daily habits and routines.

    Here are the most important lifestyle and self-care tips to incorporate into a treatment plan for fibromyalgia.

    1. Relaxation Strategies

    Meditation and mindfulness therapies can help to relieve stress and reduce symptoms of fibromyalgia.

    Here are some common ways to promote relaxation:

    1. Deep, rhythmic breathing — meditation and relaxation exercises are profoundly helpful for stress-related conditions like fibromyalgia. There are a plethora of useful applications that can be downloaded to your device for free to help you get started. Alternatively, you can attend meditation or yoga classes.
    2. Counseling — talking through your stresses and concerns with a professional counselor is particularly beneficial if you have a history of physical or emotional trauma.
    3. Biofeedback — a machine that can help read the body’s signals to reduce pain.
    4. Behavioral cognitive therapy — visit a behavioral cognitive therapist who can help you to manage emotional stress.

    2. Sleep Hygiene

    Sleep is essential for optimal health. When we’re sleep-deprived, it becomes more difficult to manage stress, leading to increased symptoms in fibromyalgia sufferers.

    Adults should get at least 7-8 hours of sleep per night.

    Sleep Hygiene Tips:

    1. Set a routine — ensure you’re following regular bedtime and wake-up times, including weekends!
    2. Meditation — meditation in the evenings primes the nervous system for sleep by relaxing the body and turning down the stress response.
    3. Warm baths with Epsom Salts — magnesium salts relax the muscles and ease the tension that may be keeping us up at night.
    4. Minimize noise — wearing earplugs can help us get to sleep faster for people sensitive to sounds.
    5. Avoid napping during the day — if you need to nap, try to keep it to less than 30 minutes, and no later than 3 pm.
    6. Avoid stimulants — like caffeine, alcohol, and cigarettes (especially after 1 pm)

    3. Regular Exercise

    Exercise may be the last activity on your mind when you’re experiencing pain and fatigue. However, appropriate gentle exercises including walking, swimming, cycling, Pilates, yoga, and Tai Chi can help to ease pain and improve mood.

    Remember to take small steps and don’t overdo it.

    4. Eat a Balanced Diet

    Eating a well-balanced diet and avoiding processed foods high in saturated fats and sugar can reduce inflammation and ease symptoms of fibromyalgia.

    People with fibromyalgia often see their symptoms worsen when consuming foods with additives such as MSG and nitrates, and artificial sweeteners.

    Eat to Increase Energy

    Excessive fatigue is one of the most common symptoms of fibromyalgia. Eating certain whole and fresh foods high in fiber and low in sugar can provide you with more energy. Increase your intake of foods such as nuts, seeds, and dark leafy greens.

    Follow a Low FODMAP Diet

    A recent study found that following a low fermentable oligo-di-mono-saccharides and polyols (FODMAP) diet is a nutritionally balanced approach that leads to both weight loss and reduced severity of fibromyalgia symptoms [11]. FODMAP diets are not meant to be used for the long term but can be useful during flare-ups.

    Go Vegetarian or Vegan

    A recent 2018 study found that following a lacto-vegetarian diet for just 4 weeks resulted in reduced pain and improved body composition. The study also involved physiotherapy; therefore the combination of treatments may have improved the outcome [12].

    Increase Your Magnesium

    There may be a link between magnesium deficiency and fibromyalgia symptoms. Increase your consumption of magnesium-rich foods such as green leafy vegetables, nuts and seeds, legumes, and seafood.

    Avoiding Gluten

    Studies have shown that removing foods that contain gluten can reduce pain and inflammation, even if you don’t have Celiac disease [13].

    Key Takeaways: Using CBD For Fibromyalgia

    Fibromyalgia can be a debilitating condition to live with, heavily impacting an individual’s mental health and motivation.

    While there is no cure for fibromyalgia, there are steps you can take to reduce and better manage the symptoms.

    More clinical trials are needed — however, research shows that CBD can be a safe and effective treatment in relieving many of the symptoms associated with the condition, significantly improving quality of life.

    CBD has been shown to be effective for reducing pain, improving sleep, & alleviating migraines in fibromyalgia patients.